【摘要】 目的总结体外循环心内直视术后尖端扭转型室性心动过速的病因及其治疗方法。方法回顾性分析我院2004年7月至2005年10月675例体外循环心内直视手术后所发生的7例尖端扭转型室性心动过速患者的临床资料。结果7例患者中男性4例,女性3例,年龄1.5～70岁,平均41.1±24.5岁,其中法洛四联症根治术1例,冠状动脉旁路移植术1例,人工瓣膜置换术5例,合并完全性房室传导阻滞1例,合并低钾或低镁血症4例,合并高钾血症2例。心律失常发作时间距体外循环结束10～36小时,平均15.5±8.1小时。经静脉应用硫酸镁及利多卡因和异丙肾上腺素等药物治疗,全部患者均成功复律。结论体外循环心内直视术后合并完全性房室传导阻滞、电解质失衡是诱发尖端扭转型室性心动过速的主要原因,静脉注射硫酸镁、利多卡因和异丙肾上腺素联合应用是有效的抢救治疗措施。更多还原

【Abstract】 Objective To summarize the feature and treatment of torsades de pointes after open heart surgery. Methods The clinical data of 7 patients with torsades de pointes treated in our hospital from 2004 to 2005 were analyzed retrospectively. Results Of the 7 patients, 4 were male and 3 were female. The patients age ranged from 1.5 to 70 years, and the average age was 41.1 ± 24.5. There were one case of congenital heart disease, one of coronary heart disease and 5 of valvular heart disease. One patient suffered from Ⅲ°A-V block, 4 hypokalium or hypomagnesium, and 2 hyperkalium. After injected with magnesium sulfate, lidocaine and isopadrenalin, all 7 patients with torsades de pointes recovered the normal rhythm. Conclusion The main reasons for torsades de pointes after open-heart surgery are Ⅲ°A-V block and electrolyte disturbance. It is an efficient treatment by injecting magnesium sulfate, lidocaine and isopadrenalin.更多还原